I had been put on Plaquenil (hydroxychloroquine) before MTX (methotrexate). I was started on 400mg a day as my first treatment. It helped a tiny bit with fatigue, but that was it. I fired my Dr at that point, but that's a whole different story. When I started seeing my new Dr, he kept me on the plaquenil and started me on MTX as I had been on the plaquenil for 3 months already with VERY little improvement. So I'm now at 20 MG MTX and 400mg plaquenil. I just did a deep dive Michele. I'm curious for myself as well, so I will share with you what I learned.

Once you hit 20 MG of MXT, your gut can hit a ceiling, meaning you aren't absorbing all of the MXT that you are putting in your body. However, if it did work for you at one point, you can switch to injections to see if that helps, as your body will absorb nearly 100% of that. If the MTX did not help at all after 6 moths, it is probably time to make a change. If MTX is the only medication you are on, they might add a second one, such as plaquenil or there are 2 others they can add in these early stages. Maybe even a biologic can be added, depending on what your insurance will allow.

In my case I think I will ask to switch to an injection when I go on Monday. What I read said that switching would be reasonable in my situation. So I will see about that for myself since I'm not at the 6 month mark yet.

If it is snowing, he will do a televisit.

Michelle my Rheumatologist is 2.5 hours one way. Makes it a 5 hour day

Right now every 3 mos

Your Dr. will always give you a choice. How often do you see the Dr? I have been going every 6 weeks to check on blood work and see how things are going. If you want to wait and see how it's going until your next appointment, then do that. You can always make an appointment before your next one if you decide it's not going the way you want it to or feel like it should.